Peer-reviewed article
Use of transcutaneous bilirubinometers in preterm infants in Japan.
Xu Y, Sato Y, Morioka I, Iwatani S, Kunikata T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study surveyed 229 Japanese facilities to assess how transcutaneous bilirubinometers (devices that measure jaundice without blood tests) are used in preterm infants. About half of facilities use these devices, with more common use in smaller hospitals and in older preterm infants. The study found variation in when devices are introduced and which treatment guidelines are followed.
Key points
- 51% of 149 responding facilities use transcutaneous bilirubinometers in preterm infants
- Use is more common in Level II facilities (63%) than Level III/IV facilities (40%)
- Device use increases with gestational age; late preterm infants are monitored immediately after birth while extremely preterm infants are monitored after one week
- JM-105 is the most commonly used device model
- 55% of facilities using devices adopted Morioka's treatment criteria for neonatal jaundice
Limitations
This is a descriptive survey of current practice and device usage patterns, not an evaluation of whether transcutaneous bilirubinometers improve health outcomes for preterm infants. The survey cannot determine the clinical effectiveness of the devices or whether outcomes differ between facilities using different protocols.
Abstract
Background This study aimed to investigate the current use of transcutaneous bilirubinometers (TcBMs) in preterm infants in Japan, given their potential for noninvasive and prolonged jaundice monitoring. Methods A nationwide questionnaire survey was conducted across 229 facilities for preterm infants. Responses were stratified by facility level and analyzed using Fisher's exact test. Results Of the 229 facilities, 149 (65%) responded, with 76 (51%) using TcBMs in preterm infants. TcBM use increased with gestational age. TcBMs were more commonly used in Level II facilities than in Level III/IV facilities (63% vs. 40%, p = 0.0087). In late preterm infants, TcBMs tended to be used immediately after birth, whereas in extremely preterm infants, they were often introduced after the first postnatal week. Level II facilities showed a tendency to use TcBMs immediately after birth, even in infants of relatively low gestational age. JM-105 was the most used device, and the anterior chest was the primary measurement site. 55% of the facilities using TcBMs reported adopting Morioka's new treatment criteria for neonatal jaundice. While most facilities disinfected devices after each use, concerns remained regarding measurement accuracy and infection control. Conclusion TcBMs are used in approximately half of the facilities in Japan, with greater use in Level II centers. Broader dissemination of guidelines may encourage safer and more consistent practices.